CN109414192B

CN109414192B - Monitoring bone properties

Info

Publication number: CN109414192B
Application number: CN201780041880.9A
Authority: CN
Inventors: J·范贝克尔
Original assignee: Koninklijke Philips NV
Current assignee: Koninklijke Philips NV
Priority date: 2016-07-06
Filing date: 2017-07-06
Publication date: 2022-02-18
Anticipated expiration: 2037-07-06
Also published as: WO2018007546A1; EP3481283A1; RU2019103334A3; JP2019523675A; US11234636B2; JP6538289B1; CN109414192A; RU2748048C2; EP3481283B1; US20210275086A1; RU2019103334A; US20220151546A1

Abstract

The present disclosure relates to methods and devices for monitoring bone characteristics of various conditions, such as osteoporosis and/or periodontitis. In various embodiments, a dental hygiene implement (100) may comprise: a handle (102) adapted to be held by a user; a tool (106) secured to the handle to perform a task related to dental hygiene; a transmitter (114A, 116, 360A) mounted on the dental hygiene implement to transmit wave(s) (252, 362) towards a mandible (250, 350) of a user; a sensor (114B, 116, 360B) mounted on the dental hygiene implement to detect wave(s) (254, 364) propagating away from the mandible, wherein the detected wave(s) originate from or are caused by the transmitted wave(s); and a controller (108) communicatively coupled with the emitter(s) and the sensor(s). The controller may: receiving signal(s) from sensor(s) indicative of the detected waves; and determining bone characteristic(s) of the user based on the signal(s).

Description

Monitoring bone properties

Technical Field

The present disclosure relates generally to health care. More particularly, but not exclusively, various methods and devices disclosed herein relate to monitoring bone characteristics for conditions such as osteoporosis and/or periodontitis.

Background

Osteoporosis is a skeletal disease characterized by low bone mass and a deterioration in the microstructure of bone tissue. Osteoporosis may be evidenced by less than peak bone mass and/or greater than normal bone loss. It may lead to increased bone fragility, which in turn may increase the risk of fractures, including non-traumatic and/or spontaneous fractures. Osteoporosis is the most common cause of fractures in elderly patients. In most cases, there are few symptoms before the fracture. Osteoporosis may have various causes. For example, bone loss may increase in postmenopausal female patients due to decreased estrogen levels. Other causes may include alcohol abuse, anorexia, hyperthyroidism, surgical removal of ovaries, kidney disease, exercise deficiency, smoking, and certain medications. Osteoporosis may be diagnosed in some cases when a patient has a bone density 2.5 standard deviations below that of a typical young adult.

Early detection of bone loss may facilitate treatment, for example, using diphosphate or hormone treatment to slow the rate of bone loss. However, existing techniques and devices for detecting bone loss tend to be invasive, expensive and/or generally available only in medical offices. For example, dual energy X-ray absorptiometry (DEXA) may be used to measure bone mineral density ("BMD"). However, due to cost, maintenance, size and exposure to potentially harmful X-rays, it is necessary to use DEXA equipment that is not suitable for use in a home environment. In addition, there is some controversy as to whether BMD is an accurate predictor of osteoporosis. Quantitative ultrasound ("QUS") may also be employed, for example, to measure bone density at the heel and/or carpal bones of a patient, but is also impractical for home use.

US 2008/060148 discloses a sensor-responsive toothbrush capable of adjusting its output or operation depending on information received by one or more sensors incorporated in the toothbrush or selected by the user. The information typically relates to a specific condition or the presence of a specific substance or agent within or outside the oral cavity. The sensor-responsive toothbrush further includes one or more responsive output components that provide a responsive output in response to the sensed information. A method of providing oral care benefits comprising the steps of: activating a toothbrush comprising a sensor; detecting a sensor input with the sensor; and initiating a responsive output from the toothbrush in response to the sensor input.

WO 2007/004604 discloses a small, low cost, non-invasive bone density measuring device.

US 2006/192965 discloses a method and a device for assessing bone tissue, comprising the following steps and units for: exposing the sample to non-ionizing radiation; detecting non-ionizing radiation after transport in the bone tissue; measuring optical properties from the detected non-ionizing radiation using a continuous wave model, a frequency domain model, or a combination of a wave model and a frequency domain model to characterize bone tissue across an entire selected spectral range; and determining the composition, structure, physiology, or a combination thereof of the bone tissue from the measured optical properties.

US 2013/080295 discloses an oral health care implement and system for use during oral health care activities. The oral health care implement has a proximity sensor, most commonly in embodiments of a capacitive sensor. Proximity sensors provide time of use and instance measurements in a number of proposed formats. The oral health care system has an oral health care implement, a first data transmission medium, and any combination of: a second data transmission medium, a network storage device, and a third data transmission medium. The system provides a means for collecting usage measurements via an oral health care implement and transmitting the data into a user-readable, usable form.

Disclosure of Invention

The present disclosure relates to methods and devices for monitoring bone characteristics of conditions such as osteoporosis and/or periodontitis. It is generally accepted in the medical community that there is a correlation between systemic osteoporosis and mandibular or mandibular osteoporosis. Thus, various techniques are described herein for enabling routine (e.g., periodic), non-intrusive, non-radiation-based, easily conducted self/home monitoring assessment of mandible density and composition as a surrogate for systemic bone density and composition, for example to provide systemic osteoporosis monitoring.

In various embodiments, non-obtrusive, non-invasive, easy-to-use items typically found in bathrooms, such as dental hygiene implements (e.g., toothbrushes, sprinklers, etc.), holders, nipples, or appliances such as electric shavers, may be equipped with various types of sound and/or light emitters and/or sensors. These emitters/sensors may be configured to: light waves are emitted towards the mandible of the user with or without sound waves, and corresponding light waves are detected with or without sound waves propagating out of the mandible. These detected light waves, with or without acoustic waves, may be analyzed to determine mandible density and/or composition, which, as mentioned above, may serve as a surrogate term for systemic bone density/composition. Incorporating such technology into everyday items, such as toothbrushes or shavers, may facilitate routine monitoring, as the devices are frequently used. It will also allow non-intrusive and non-invasive measurements. In addition, various "off-the-shelf" communication techniques may be used to enable data sharing between sensors implemented in the device and one or more remote computing devices.

In general, in one aspect, a system includes: a dental hygiene implement comprising a handle adapted to be held by a user; a tool secured to the handle and operable by the user for performing tasks related to dental hygiene; an infrared radiator mounted on the dental hygiene implement to emit infrared radiation towards the user's mandible; an infrared sensor mounted on the dental hygiene implement to detect responsive infrared radiation affected by absorption of infrared radiation by the mandible; and a controller communicatively coupled with the infrared radiator and the infrared sensor, the controller configured to: operating the infrared radiator to emit infrared radiation toward the mandible for a predetermined amount of time; receiving one or more signals from the infrared sensor indicative of the detected response infrared radiation; and determining one or more bone characteristics of the user based on the one or more signals.

In some embodiments, the dental hygiene implement may take the form of an electronic toothbrush, and the tool may be a brush. In some embodiments, the controller may be integral with the dental hygiene implement. In some embodiments, the dental hygiene implement may comprise a wireless communication interface and communicate wirelessly with the one or more sensors via the wireless communication interface.

In some embodiments, the controller may be configured to provide feature vectors extracted from the one or more signals to a trained machine learning model. The trained machine learning model may output labels indicative of one or more bone characteristics of the user. In various embodiments, the label may indicate that the user has or is at risk of osteoporosis.

In some embodiments, the controller may be configured to apply fourier transform spectroscopy to analyze scattered infrared radiation propagating from the mandible in response to infrared radiation emitted by the infrared radiator.

In some embodiments, the system further comprises one or more ultrasound transmitters and one or more ultrasound sensors, which together form an ultrasound transceiver. In some embodiments, the controller may be configured to: operating the ultrasonic transceiver to transmit ultrasonic waves toward the mandible; and analyzing signals generated by the ultrasonic transceiver to measure a vibrational response to the transmitted ultrasonic waves.

In some embodiments, at least one of the one or more emitters is an ultrasonic applicator (insonator) and at least one of the one or more sensors is an ultrasonic sensor. In some embodiments, the controller may be configured to: operating the ultrasonic applicator to pass ultrasonic waves through the mandible towards the ultrasonic sensor; and determining a speed of the ultrasound waves through the mandible or a measure of attenuation in the ultrasound waves caused by the mandible based on the signals from the ultrasound sensors.

It should be appreciated that all combinations of the foregoing concepts and additional concepts discussed in greater detail below (provided such concepts do not contradict each other) are contemplated as being part of the subject matter disclosed herein. In particular, all combinations of claimed subject matter appearing at the end of this disclosure are contemplated as being part of the subject matter disclosed herein. It should also be appreciated that terms explicitly employed herein may also appear in any disclosure incorporated by reference, and should be given the most consistent meaning to the particular concepts disclosed herein.

Drawings

In the drawings, like reference numerals generally refer to the same parts throughout the different views. Likewise, the drawings are not necessarily to scale, emphasis instead generally being placed upon illustrating the principles of the disclosure.

FIG. 1 illustrates an example environment in which the disclosed techniques can be practiced in accordance with various embodiments.

Fig. 2 depicts an example dental appliance assembly using ultrasound and vibration response to detect bone properties in the mandible.

Fig. 3 depicts an example dental appliance assembly for detecting bone properties by illuminating the mandible with infrared radiation and observing the response to the illumination.

Fig. 4 depicts an example graph depicting absorbance at various infrared wavelengths due to various bone properties, in accordance with various embodiments.

Fig. 5 depicts an example method of non-invasively monitoring bone characteristics of a condition, such as osteoporosis, in accordance with various embodiments.

FIG. 6 depicts an example computer system.

Detailed Description

Osteoporosis is a skeletal disease characterized by low bone mass and a deterioration in the microstructure of bone tissue. In many cases, there are few symptoms before fracture. Early detection of bone loss may assist in the treatment, but existing techniques and equipment for detecting bone loss tend to be invasive, expensive and/or generally available only in medical offices. Accordingly, there is a need in the art to provide an unobtrusive, non-invasive, easy to use, and inexpensive way to monitor bone properties periodically (e.g., daily, weekly, semi-daily, etc.). In view of the foregoing, various embodiments and implementations of the present disclosure relate to non-invasively monitoring bone characteristics for conditions such as osteoporosis.

Referring to FIG. 1, in one embodiment, a dental hygiene implement having selected aspects of the present disclosure is depicted in the form of an electronic toothbrush 100. The electronic toothbrush 100 includes: a handle 102 adapted to be held by a user (not depicted), a neck 104 connected to the handle 102, and a tool in the form of a brush 106 at an end of the neck 104 opposite the handle 102. Although the dental hygiene implement depicted in fig. 1 is an electronic toothbrush, this is not meant to be limiting. In various embodiments, other dental and non-dental related appliances may be configured with selected aspects of the present disclosure, including, but not limited to: non-electric toothbrushes, shavers, sprinklers, nipples, holders, and the like. In some embodiments, selected aspects of the present disclosure may be utilized to configure a device for bone monitoring only, and not for any other dental hygiene related task.

In various embodiments, toothbrush 100 may include internal logic 108, and in some cases, may include one or more communication interfaces 110 operably coupled with logic 108. Logic 108 may take various forms. In some embodiments, logic 108 takes the form of one or more processors operatively coupled with memory (not depicted). The memory may store instructions that may be executed by the one or more processors to perform selected aspects of the present disclosure. In other embodiments, the logic 108 may take other forms, such as a field programmable gate array ("FPGA") and/or an application specific integrated circuit ("ASIC"). Communication interface 110 may include one or more modules to enable logic 108 to communicate with one or more remote computing devices. The communication interface 110 may employ various wired and/or wireless communication techniques, including, but not limited to: Wi-Fi, Bluetooth, near field communication ("NFC"), Edge, Ethernet, Universal Serial bus ("USB"), variations of cellular technology, and so forth.

In some embodiments, toothbrush 100 can include a pair of

retractable members

112A and 112B. The

retractable members

112A and 112B may be retractable (as shown by the arrows) between a first configuration depicted in phantom lines, in which each retractable member 112 is substantially flush with the surface of the toothbrush 100 (in this case, flush with the surface of the neck 104), and a second configuration depicted in solid lines, in which each retractable member 112 extends laterally from the surface of the toothbrush 100. In various embodiments, the

retractable members

112A and 112B may be spaced apart from each other by a predetermined distance selected such that the

retractable members

112A and 112B are far enough apart in the second configuration that they can be positioned on the side of the user's mandible (i.e., on the opposite side of the mandible).

The toothbrush 100 may include: one or more transmitters to transmit one or more sound or light waves toward the mandible of the user, and one or more sensors to detect one or more sound or light waves propagating away from the mandible. The detected one or more acoustic or light waves may originate from or be caused by the emitted one or more waves. For example, in fig. 1, toothbrush 100 includes an emitter 114A mounted on a first telescoping member 112A and a sensor 114B mounted on a second telescoping member 112B. Emitter 114A may emit acoustic or light waves toward sensor 114B. Sensor 114B may detect emitted sound or light waves.

In various embodiments, the user may extend the

retractable members

112A and 112B to the second configuration depicted in solid lines, and then position the toothbrush 100 such that the first retractable member 112A (and thus, the transmitter 114A) is on one side of the user's mandible and the second retractable member 112B (and thus, the sensor 114B) is on the opposite side of the user's mandible. In this way, the acoustic or light waves emitted by emitter 114A pass through the user's mandible before being detected by sensor 114B. As will be described in greater detail below, the logic 108 may analyze the signals provided by the sensor 114B to detect any changes or effects on the waves caused by the user's mandible. These changes or effects may be indicative of one or more bone characteristics of the user.

In fig. 1, toothbrush 100 includes additional transmitter/sensor pairs that together form transceiver 116. The transceiver 116 may transmit sound and/or light waves toward the user's mandible and may detect responsive sound or light waves propagating from the user's mandible. For example, in some implementations, the transceiver 116 may insonify the user's mandible with ultrasound and then detect a vibrational response. In other embodiments, the transceiver 116 may illuminate the user's mandible with infrared radiation and then detect the wavelength-dependent absorption of the emitted light waves. In some embodiments, toothbrush 100 may be equipped with multiple transceivers (or another emitter/sensor pair), one for emitting/detecting infrared radiation and another for emitting/detecting ultrasonic waves.

In various embodiments, the logic 108 may be configured to receive one or more signals indicative of detected waves propagating from the user's mandible from one or more sensors (e.g., 114B, 116). Logic 108 may then be configured to determine one or more bone characteristics of the user based on the one or more signals. In some embodiments, the logic 108 may provide data indicative of its analysis to a remote computing device 120 over a wireless connection (e.g., facilitated by the communication interface 110), which remote computing device 120 may be a computing device owned or operated by a user. The remote computing device 120 may take various forms, such as a smart phone, a tablet, a smart watch, a laptop computer, a desktop computer, a set-top box, and so forth. In some embodiments, the remote computing device 120 may provide various audible, visual, and/or tactile feedback to the user based on the analysis performed by the logic 108. For example, if the logic 108 (or remote computing device 120) determines that the user is experiencing excessive bone loss based on signals from the sensors 114B and/or the transceiver 116 (e.g., by comparing the current measurement to one or more previous measurements), the computing device 120 may present an alert to the user to visit their healthcare provider.

In some embodiments, the remote computing device 120 may be communicatively coupled with the healthcare provider computing device 124 through one or more wired or wireless network connections 126 (e.g., the internet). The healthcare provider computing device 124, which may take one or more of the various form factors mentioned above, may be operated by one or more healthcare providers 128. The health care provider computing device 124 may provide various types of audio, visual, and/or tactile feedback to the health care provider 128 that is indicative of one or more bone characteristics of the user. Based on this feedback, the health care provider 128 may take various responsive actions, such as initiating a treatment, suggesting a change in lifestyle, and so forth.

As mentioned above, various types of emitters and/or sensors may be employed, alone or in combination, to detect bone characteristics of a user. For example, some transmitters take the form of an ultrasound transmitter or transceiver that generates high frequency ultrasound waves to propagate toward the user's mandible when the transceiver is held against the mandible for a predetermined amount of time. The signals detected by the transceiver or a separate sensor may be indicative of the bone vibrational response and may carry information about the bone composition and/or density.

Fig. 2 depicts an example of how ultrasound waves may be used to determine one or more bone properties. Toothbrush 100 includes an ultrasonic transceiver 116. The toothbrush 100 has been introduced into position such that the ultrasonic transceiver 116 is adjacent (e.g., in contact with, within a predetermined distance of) the user's mandible 250. The ultrasound transceiver 116 transmits outgoing ultrasound waves 252 and receives responsive incoming ultrasound waves 254. The responsive input ultrasonic waves 254 may be analyzed by logic (108, see fig. 1) to determine a vibrational response. The vibrational response may be affected by, among other things, the composition of the user's mandible and/or bone density. Logic 108 may then analyze the signal generated by transceiver 116 to determine bone characteristics. For example, logic 108 may identify a trend of increasing vibration response over time, indicating that the bone density of the user is decreasing.

Another example of how ultrasound waves may be used to determine one or more bone properties is depicted in fig. 1. It is assumed that transmitter 114A is an ultrasonic transmitter (or transceiver, also referred to as an "ultrasonic applicator") and sensor 114B is an ultrasonic sensor (or transceiver). In various embodiments, once toothbrush 100 is positioned such that a portion of the user's mandible (250, see fig. 2) is between transmitter 114A and sensor 114B, transmitter 114A may transmit ultrasonic waves toward sensor 114B. The signals generated by sensor 114B in response to these detected waves may provide information about, for example, the velocity of the ultrasound waves through the mandible, or a measure of attenuation from the ultrasound waves originally transmitted from transmitter 114A. These parameters may be used by logic 108 to estimate the user's BMD, for example. Whether using the ultrasound configuration depicted in fig. 2 or fig. 1, each measurement may be analyzed, and/or measurements over time may be analyzed, for example, to identify trends in bone loss/composition/density.

Fig. 3 depicts an example of how infrared waves may be used to determine one or more bone properties. In this example, toothbrush 100 includes: an infrared emitter 360A (also referred to as a "radiator") that emits infrared radiation 362 toward the user's mandible 350; and an infrared sensor 360B configured to detect responsive infrared radiation 364 propagating from the mandible 350. In this example, emitter 360A and sensor 360B are offset from one another, rather than being formed together (as is the case with ultrasound emitter/sensor 116 in fig. 2), although this is not required. In other embodiments, a single component, such as a light emitting diode ("LED"), may be configured to both emit and detect infrared radiation. Infrared radiation 362 emitted by emitter 360A toward mandible 350 may scatter in a variety of different directions as it enters mandible 350. At least some of this scattered infrared radiation may be directed to sensor 360B and thus detected by sensor 360B, e.g., as shown at 364.

In some embodiments, such as depicted in fig. 3, infrared emitter 360A and sensor 360B may take the form of a near-infrared spectroscopy device. Once one or both of transmitter 360A and sensor 360B are pressed against mandible 350, mandible 350 may be irradiated with infrared radiation 362 for a specified amount of time (e.g., as indicated by audio and/or visual output). In some embodiments, fourier transform infrared ("FTIR") spectroscopy techniques may be employed, for example, by logic 108 to detect absorption of infrared radiation during vibrational transitions in covalently bonded atoms. This detected resorption can be analyzed to determine various bone properties affecting the so-called "bone quality". These bone properties may include factors that affect the geometric and/or material properties that contribute to fracture resistance. The geometric properties may include the macroscopic geometry of the entire mandible 350 and the microscopic architecture of the bone components. The material properties may include the composition and arrangement of the major components of bone tissue, such as collagen and minerals, as well as micro-lesions and/or micro-structural discontinuities. FTIR imaging can provide information about bone composition at the molecular level and can therefore be used as a tool to assess bone quality.

The various bone characteristics determined using the foregoing techniques may be analyzed in various ways to determine the bone health of the patient. In some embodiments, the machine learning model may be trained to receive feature vectors extracted from the various sensor signals described above, and provide outputs including labels such as "osteoporosis detected", "risk of osteoporosis detected", "osteoporosis not detected", and so forth. The machine learning model may be implemented using various techniques, including but not limited to logistic regression models or neural networks. Such machine learning models may be trained on various types of positive and/or negative training paradigms. For example, a forward training paradigm may include feature vectors associated with patients known to have healthy bone density and/or composition (and thus not exhibit osteoporosis). Negative training examples may include, for example, feature vectors associated with patients known to have unhealthy bone density and/or composition, such as osteoporosis patients.

In some implementations, when a healthy user first begins using a device, such as a toothbrush configured with selected aspects of the present disclosure, the user may establish a healthy "baseline" of one or more bone characteristics (e.g., bone density, bone composition), for example, by using a device as described above. The data collected after each subsequent use may then be compared to earlier data to determine, for example, whether any trends associated with bone loss, combined degeneration, etc. can be identified.

Although the particular embodiments described above each include a particular number of emitters and/or sensors, this is not meant to be limiting. Any number of sound and/or light emitter/sensor combinations may be employed on a single device to obtain various levels of information about the user's bone quality. For example, in some embodiments, the two types of ultrasonic emitter sensors described above (e.g., 114A/114B combination 116) may be employed together. Infrared emitters/sensors (e.g., 360A/360B) may also be used in combination with one or both types of ultrasonic emitters/sensors, or separately.

The evaluation of bone by means of reflection of ultrasound waves and by spectral analysis of the infrared light reflected by the bone provides insight into different properties and properties of the bone. The combination of these two techniques will help to better understand the quality of the bone studied. Ultrasound enables bone verification on a macroscopic scale by assessing the vibrational response of the bone, while spectral infrared techniques will allow analysis of the molecular composition of the bone, and thus the combination of infrared emitter/sensor (360A/360B) and ultrasonic emitter/sensor (114A/114B, 116) combination helps to analyze two different properties of the bone, allowing for more accurate diagnosis. The evaluation of two different parameters provides a better understanding of the quality of the bone, i.e. not only the bone density but also the bone quality, which in fact provides a better prediction of the fracture risk.

Fig. 4 depicts an example graph depicting absorbance at various infrared wavelengths due to various bone properties, in accordance with various embodiments. The X-axis represents the infrared wavelength in nm and the Y-axis represents mm^-1Absorbance in units. The top line represents the so-called "compact" or "cortical" bone. Cortical bone is much denser than the so-called "cancellous bone" or "trabecular" bone represented by the bottom three lines (e.g., 2000 mg/cm)³) In the range of 250mg/cm³To 400mg/cm³. Cortical bone is typically found near the exterior of the bone. Cancellous bone is typically located near the ends of long bones, near joints, and within vertebrae. Cancellous bone is more affected by osteoporosis than cortical bone. The example graph shows how the absorption of infrared light waves by bone changes as the density and calcium content of cancellous bone decreases due to the progression of osteoporosis.

Fig. 5 depicts an example method 500 for non-invasively monitoring bone characteristics of a condition, such as osteoporosis, in accordance with various embodiments. Although the operations of method 500 are depicted in a particular order, this is not meant to be limiting. Various operations may be added, omitted, or reordered.

At block 502, a user may position a dental hygiene implement (or another implement intended to be used periodically by the user, such as a shaver, water jet, holder, etc.) such that one or more emitters and/or sensors are adjacent to the user's mandible. For example, in fig. 1, toothbrush 100 may be positioned such that

retractable members

112A and 112B (and thus emitter 114A and sensor 114B) are located on opposite sides (i.e., sides) of the user's mandible. Alternatively, toothbrush 100 may be positioned such that neck 104 and transceiver 116 are positioned adjacent (e.g., in contact with, within a predetermined distance of, etc.) the user's mandible. In some embodiments, the operations of block 502 may occur concurrently with performance of the dental hygiene related task, but this is not required.

In some embodiments, the user may position the appliance appropriately in response to audible and/or visual instructions provided by, for example, the appliance itself and/or a nearby computing device (e.g., 120). For example, toothbrush 100 may be paired with a user's smart phone, tablet, smart mirror, etc. (e.g., using bluetooth). The user can launch an application on the paired device that provides instructions to the user while brushing. The application may also provide an output instructing the user to position the toothbrush 100 as described above, for example before or after brushing. For example, the user may be instructed to place the neck 104 against their left or right mandible on their gums and under their teeth. Once toothbrush 100 is properly positioned, the user may initiate the emission of light or sound waves for a predetermined time interval, for example, by pressing an actuator. In some embodiments, the paired device or toothbrush 100 may provide audio, visual, and/or tactile feedback indicating that a predetermined time interval has been reached (or that sufficient measurements have been captured) so that the user can remove the toothbrush from his or her lower jaw. In some embodiments, if the obtained measurement is not sufficient (e.g., the toothbrush 100 that the user moved during the measurement), the paired device or toothbrush 100 may instruct the user to resume the measurement.

In some embodiments, the toothbrush 100 may include an actuator (not depicted, e.g., a button or pressure release below the

retractable members

112A and 112B) operable to transition the

retractable members

112A and 112B between the first and second configurations depicted in fig. 1. For example, the user can operate the actuator after brushing is complete, e.g., so that the

retractable members

112A and 112B do not interfere while brushing. In some embodiments, the

retractable members

112A and 112B can be automatically extended from the toothbrush to the second configuration, for example, after a pre-programmed brushing routine has been completed.

At block 504, logic 108 may cause one or more transmitters (e.g., 114A, 116, 360A) to transmit light waves with or without sound waves, for example, toward a mandible of the user for a predetermined amount of time. For example, once the user has properly positioned toothbrush 100 as described above, the user may press a button, causing the launch to begin, e.g., seconds, etc. At block 506, light waves further with or without acoustic waves propagating away from the user's mandible may be detected by one or more sensors (e.g., 114B, 116, 360B).

At block 508, a signal indicative of the light waves detected at block 506 with/without one or more acoustic waves may be provided to the logic 108, e.g., by one or more sensors (e.g., 114B, 116, 360B). At block 510, logic 108 may analyze the signals to determine one or more bone characteristics of the user as described above. As mentioned above, these bone properties may include, but are not limited to, bone density, composition, and the like. In some embodiments, rather than the logic 108 being integrated with the toothbrush to determine the bone characteristic, the logic 108 may simply provide data indicative of the sensor signal to one or more remote computing devices (e.g., 120, 124). This may be particularly the case where toothbrush 100 is a resource constrained device that may lack sufficient processing power and/or battery power to perform calculations on its own.

FIG. 6 is a block diagram of an example computer system 610. Computer system 610 typically includes at least one processor 614, which communicates with a number of peripheral devices via a bus subsystem 612. As used herein, the term "processor" will be understood to encompass a variety of devices, such as, for example, microprocessors, FPGAs, ASICs, other similar devices, and combinations thereof, capable of performing the various functions attributed to the various components described herein. These peripheral devices may include: data retention subsystem 624 including, for example, memory subsystem 625 and file storage subsystem 626; a user interface output device 620; a user interface input device 622, and a network interface subsystem 616. The input and output devices allow a user to interact with computer system 610. Network interface subsystem 616 provides an interface to an external network and is coupled to corresponding interface devices in other computer systems.

The user interface input devices 622 may include a keyboard, a pointing device such as a mouse, trackball, touchpad, or tablet, a scanner, a touch screen incorporated into a display, an audio input device such as a voice recognition system, microphone, and/or other types of input devices. In general, use of the term "input device" is intended to include all possible types of devices and ways to input information to computer system 610 or a communication network.

User interface output devices 620 may include a display subsystem, a printer, a facsimile machine, or a non-visual display such as an audio output device. The display subsystem may include a Cathode Ray Tube (CRT), a flat panel device such as a Liquid Crystal Display (LCD), a projection device, or some other mechanism for producing a visible image. The display subsystem may also provide non-visual displays, such as via an audio output device. In general, use of the term "output device" is intended to include all possible types of devices and ways to output information from computer system 610 to a user or to another machine or computer system.

Data retention system 624 stores programming and data structures that provide the functionality of some or all of the modules described herein. For example, the data retention system 624 may include logic for performing selected aspects of the method 500, and/or logic for implementing one or more components of the toothbrush 100, the remote computing device 120, and/or the healthcare provider computing device 124.

These software modules are typically executed by processor 614 alone or in combination with other processors. The memory 625 used in the memory subsystem can include a plurality of memories including a main Random Access Memory (RAM)630 for storing instructions and data during program execution, a Read Only Memory (ROM)632 storing fixed instructions, and other types of memories such as an instruction/data cache (which may additionally or alternatively be integrated with the at least one processor 614). File storage subsystem 626 is capable of providing persistent storage for program and data files, and may include a hard disk drive, a floppy disk drive along with associated removable media, a CD-ROM drive, an optical disk drive, or removable media cartridges. Modules implementing the functionality of particular embodiments may be stored by file storage subsystem 626 in data retention system 624, or in other machines accessible to processor(s) 614. As used herein, the term "non-transitory computer readable medium" will be understood to encompass volatile memory (e.g., DRAM and SRAM) and non-volatile memory (e.g., flash memory, magnetic storage, and optical storage), but to exclude transient signals.

Bus subsystem 612 provides a mechanism for the various components and subsystems of computer system 610 to communicate with one another as intended. Although bus subsystem 612 is shown schematically as a single bus, alternative implementations of the bus subsystem may use multiple buses.

Computer system 610 may be of various types, including a workstation, a server, a computing cluster, a blade server, a server farm, or any other data processing system or computing device. In some embodiments, computer system 610 may be implemented within a cloud computing environment. Due to the ever-changing nature of computers and networks, the description of computer system 610 depicted in FIG. 6 is intended only as a specific example for purposes of illustrating some embodiments. Many other configurations of computer system 610 are possible with more or fewer components than the computer system depicted in FIG. 6.

While several embodiments have been described and illustrated herein, those of ordinary skill in the art will readily envision a variety of other means and/or structures for performing the function and/or obtaining the result and/or one or more of the advantages described herein, and each of such variations and/or modifications is deemed to be within the scope of the embodiments described herein. More generally, those skilled in the art will readily appreciate that all parameters, dimensions, materials, and configurations described herein are intended to be exemplary and that the actual parameters, dimensions, materials, and/or configurations will depend upon the specific application or applications for which the teachings is/are used. Those skilled in the art will recognize, or be able to ascertain using no more than routine experimentation, many equivalents to the specific embodiments described herein. It is, therefore, to be understood that the foregoing embodiments are presented by way of example only and that, within the scope of the appended claims and equivalents thereto, the embodiments may be practiced otherwise than as specifically described and claimed. Embodiments of the present disclosure are directed to each individual feature, system, article, material, kit, and/or method described herein. In addition, any combination comprising two or more such features, systems, articles, materials, kits, and/or methods, if such features, systems, articles, materials, kits, and/or methods are not mutually inconsistent, is within the scope of the present disclosure.

All definitions, as defined and used herein, should be understood to control dictionary definitions, definitions in documents incorporated by reference, and/or ordinary meanings of the defined terms.

The indefinite articles "a" and "an" as used in this specification and in the claims should be understood to mean "at least one" unless expressly specified to the contrary.

The phrase "and/or" as used in this specification and claims should be understood to mean "one or two" of the elements so combined, i.e., elements that are present in combination in some cases and are present in isolation in other cases. Multiple elements listed with "and/or" should be construed in the same manner, i.e., "one or more" elements so combined. In addition to elements specifically identified in the "and/or" clause, other elements may optionally be present, whether or not related to those specifically identified elements. Thus, as a non-limiting example, when used in conjunction with open language such as "including," references to "a and/or B" may refer in one embodiment to only a (optionally including elements other than B); in another embodiment, only B (optionally including elements other than a); in yet another embodiment, refer to both a and B (optionally including other elements); and so on.

As used in this specification and claims, "or" should be understood to have the same meaning as "and/or" as defined above. For example, when separating items in a list, "or" and/or "should be interpreted as being inclusive, i.e., comprising at least one, but also including more than one of a plurality of elements or list of elements, and optionally other unlisted items. Only terms explicitly indicating the contrary, such as "only one" or "exactly one", or, when used in the claims, "consisting of" will mean to include exactly one of the elements or list of elements. In general, the term "or" as used herein before an exclusive term such as "any," "one," "only one," or "exactly one" should only be construed to mean an exclusive alternative (i.e., "one or the other but not both"). "consisting essentially of" when used in the claims shall have its ordinary meaning as used in the art of patent law.

As used in this specification and the claims, the phrase "at least one," in reference to a list of one or more elements, should be understood to mean at least one element selected from any one or more of the elements in the list of elements, but not necessarily including at least one of each element specifically listed in the list of elements, and not excluding any combinations of elements in the list of elements. This definition also allows that elements optionally are present, whether related or not to those specifically identified, in addition to the elements specifically identified within the list of elements to which the phrase "at least one" refers. Thus, as a non-limiting example, "at least one of a and B" (or, equivalently, "at least one of a or B," or, equivalently "at least one of a and/or B") may refer, in one embodiment, to at least one, optionally including more than one, a, with no B present (and optionally including elements other than B); in another embodiment, refers to at least one, optionally including more than one, B, with no a present (and optionally including elements other than a); in yet another embodiment, refers to at least one, optionally including more than one, a, and at least one, optionally including more than one, B (and optionally including other elements); and so on.

It will also be understood that, unless explicitly stated to the contrary, in any methods claimed herein that include more than one step or action, the order of the steps or actions of the method is not necessarily limited to the order in which the steps or actions of the method are recited.

In the claims, as well as in the specification above, all conjunctive phrases such as "comprising," including, "" carrying, "" having, "" containing, "" involving, "" holding, "" consisting of,. or the like, are to be understood to be open-ended, i.e., to mean including but not limited to. Only the conjunctive phrases "consisting of and" consisting essentially of shall be closed or semi-closed conjunctive phrases, respectively, as described in the U.S. patent office patent examination program manual section 2111.03. It should be understood that the particular expressions and reference signs used in the claims in accordance with the patent Cooperation treaty ("PCT") convention 6.2(b) are not limiting in scope.

Claims

1. A healthcare system comprising:

a dental hygiene implement (100) comprising a handle (102) adapted to be held by a user;

a tool secured to the handle and operable by the user for performing dental hygiene related tasks;

an infrared radiator (360A) mounted on the dental hygiene implement to emit infrared radiation (362) towards the user's mandible (250, 350);

an infrared sensor (360B) mounted on the dental hygiene implement to detect responsive infrared radiation (364) affected by absorption of infrared radiation by the mandible; and

a controller communicatively coupled with the infrared radiator and the infrared sensor, the controller configured to:

operating the infrared radiator (360A) to emit infrared radiation (362) toward the mandible for a predetermined amount of time;

receiving one or more signals indicative of the detected responsive infrared radiation (364) from the infrared sensor (360B); and is

Determining one or more bone characteristics of the user based on the one or more signals.

2. The healthcare system according to claim 1, wherein the dental hygiene implement comprises an electronic toothbrush and the tool comprises a brush (106).

3. The health care system of claim 1, wherein the controller is integral with the dental hygiene implement.

4. The healthcare system according to claim 1, wherein the dental hygiene implement comprises a wireless communication interface (110), and the controller is in wireless communication with the one or more sensors via the wireless communication interface.

5. The healthcare system of claim 1, wherein the controller is configured to provide feature vectors extracted from the one or more signals to a trained machine learning model, and wherein the trained machine learning model outputs labels indicative of one or more bone characteristics of the user.

6. The healthcare system of claim 5, wherein the label indicates that the user has osteoporosis.

7. The healthcare system of claim 5, wherein the label indicates that the user is at risk for osteoporosis.

8. The healthcare system according to claim 1, wherein the controller is configured to apply Fourier transform spectroscopy to analyze scattered infrared radiation propagating from the mandible in response to infrared radiation emitted by the infrared radiators.

9. The healthcare system of claim 1, further comprising one or more ultrasound transmitters and one or more ultrasound sensors, which together form an ultrasound transceiver (116).

10. The healthcare system of claim 9, wherein the controller is configured to:

operating the ultrasonic transceiver to transmit ultrasonic waves (252) toward the mandible; and is

Analyzing signals generated by the ultrasonic transceiver to measure a vibrational response to the transmitted ultrasonic waves.

11. The healthcare system according to claim 1, further comprising an ultrasound applicator (114A) and an ultrasound sensor (114B).

12. The healthcare system of claim 11, wherein the controller is configured to:

operating the ultrasonic applicator to pass ultrasonic waves through the mandible towards the ultrasonic sensor; and is

Determining a measure of a velocity of the ultrasonic waves through the mandible or an attenuation of the ultrasonic waves caused by the mandible based on signals from the ultrasonic sensors.

13. The healthcare system according to claim 2, wherein the infrared radiator and the infrared sensor are mounted on respective retractable members (112A, 112B) of the toothbrush, the retractable members being spaced apart from each other by a predetermined distance, wherein each retractable member is retractable between a first configuration in which the retractable member is substantially flush with a surface of the toothbrush and a second configuration in which the retractable member extends laterally from the surface of the toothbrush, wherein the predetermined distance is selected such that the retractable members in the second configuration are spaced apart to lie on a side of a mandible of the user.